First Name

Last Name

Email Address

Mobile No

Are you living in Qatar? Are you living in Qatar? Yes No

Write your QID number

Are you own a registered company in Qatar or individual reseller? Are you own a registered company in Qatar or individual reseller? Company Individual

Your complete house address in Qatar

Your complete company name

Do you own any Facebook page or Website? Do you own any Facebook page or Website? Yes No

Please enter your Facebook page/ Website link.

Do you sell online or on physical store? Do you sell online or on physical store? Online Physical Shop Both

Please write your Physical Store address.

Select the most preferable item range. Select the most preferable item range.Himalayan Salt LampsHimalayan Salt Spa ProductsHimalayan Edible Salt

Preferable mode of payment? Preferable mode of payment? Cash Cheque Bank Transfer

Further information